Epidemiology
Over 30% of screened Portuguese children have intermediate or high Lp(a), real-world pediatric study finds (Clin Exp Pediatr 2025)
Original title: Lipoprotein(a) prevalence trends in Portuguese children and adolescents: a real-world perspective
This cross-sectional retrospective study examined 792 Portuguese pediatric patients who underwent Lp(a) testing as part of lipid disorder screening prompted by obesity, hypercholesterolaemia or a family history of premature cardiovascular disease, categorising Lp(a) as below 75 nmol/L, 75 to 125 nmol/L, or above 125 nmol/L. Median Lp(a) was 31.80 nmol/L, with 9.1% of children in the intermediate range and 21.6% in the high range, together placing over 30% at intermediate or high cardiovascular risk. Higher total cholesterol, non-HDL cholesterol and LDL-C correlated with elevated Lp(a), and multivariate analysis identified elevated LDL-C as a predictor of higher Lp(a). Given that Lp(a) is largely genetically fixed and tends to persist into adulthood, the authors argue this real-world prevalence supports incorporating Lp(a) screening into pediatric cardiovascular risk assessment to enable earlier prevention.
Original abstract
Background: Lipoprotein(a) (Lp(a)) is a plasma lipoprotein with atherogenic, prothrombotic, and proinflammatory properties. Elevated Lp(a) levels are linked to the development of early atherosclerosis in childhood and contribute to a higher risk of cardiovascular disease (CVD) in adulthood.
Purpose: This study aimed to assess the clinical significance of Lp(a) levels in Portuguese pediatric patients who underwent serum Lp(a) testing as part of a lipid disorder screening prompted by obesity, hypercholesterolemia, and/or a family history of premature CVD. We also evaluated the correlation between Lp(a) levels and CVD risk factors.
Methods: This cross-sectional retrospective study included 792 pediatric patients. Data on demographics, clinical history, body mass index, and laboratory values, including Lp(a), were collected. Lp(a) levels were categorized into 3 groups: <75 nmol/L, 75-125 nmol/L, and >125 nmol/L. A multivariate analysis was used to identify factors associated with Lp(a) ≥ 75 nmol/L.
Results: The most prevalent comorbidities in this sample were obesity and associated low-grade inflammation, each affecting at least one-third of participants. The median Lp(a) level was 31.80 nmol/L, with 9.1% and 21.6% of children having intermediate (75-125 nmol/L) and high (>125 nmol/L) Lp(a) levels, respectively. Higher total cholesterol, non-high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol (LDL-C) levels were correlated with elevated Lp(a) levels. The multivariate analysis identified an elevated LDL-C level as a predictor of a higher Lp(a) level.
Conclusion: This study highlights the alarming prevalence of elevated Lp(a) levels in Portuguese pediatric patients who underwent serum Lp(a) testing due to lipid disorder screening, with >30% at intermediate/high CVD risk. As Lp(a) levels are mostly genetically determined and tend to persist into adulthood, these findings emphasize the importance of including Lp(a) screening in the cardiovascular risk assessment of children with CVD risk factors to enable timely prevention strategies for adultonset CVD.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.